Grange takes centre stage

Every year it invites someone whose work has had, or has to potential to have a profound effect on public health to deliver an annual lecture. Recent lectures have been delivered by the Prime Minister of Norway in 2006, and 2 Nobel Prize lauretes in 2005 and 2004.

This year it is being delivered by the Honourable Minister of Health of Nigeria; Prof. Adenike Grange. Professor Grange, has served in several capacities, most importantly as the President of the International Paediatric Association. She has authored over fifty scientific papers in national and international peer-reviewed journals. Now she has been given her biggest responsibility yet; to improve the health and manage the health care of the 140 million people in Africa’s most populous nation.

But why would The Lancet be interested in hearing from Nigeria’s minister of health? The Lancet seeks to be…and probably is the authoritative voice in global medicine. It has taken a proactive stand in recent years in highligting the challenges of health and healthcare in Africa. In population health terms, for Africa to make progress, Nigeria must engage.

The eradication of polio, a programme into which the international community has spent about $5billion, primarily depends on success in Nigeria. The first outbreak of Avian Influenza was reported in Nigeria. Routine immuisation coverage remain below 50%…challenges abound. While other sectors that affect our existence in Nigeria have undergone profound change in recent years, the health sector has basically remained still. While it is now easy to draw cash from ATMs, to make calls from the remotest village, it is still normal for a child to die from measles or to wait for a full day to be seen in a public hopsital, only to be given a list of medicines to buy privately.

But this does not have to be the case, and in Prof. Grange, Nigerians have put thier trust to change things. Prof. Grange has been making all the right noises. She recently announced a plan to set up a National Public Health Agency, and a Commision to manage our disparate teaching hospitals. She has set a target for the elimination of polio in Nigeria in 2009. For the first time in decades, we are hearing about health targets from the ministry of health! (as previous ministers chose to focus on the number of primary health care centres built, with no comment on how many are actually providing health care). Nigerians are hopeful.

Tomorrow, the international public health community will have the priviledge to listen to Prof Grange outline her plans. Her talk is aptly titled “Implementing health sector reform for better performance”. “Health sector reform” has been bandied around for years in Nigeria, but not many people can identify how it has affected their lives other than the 1% of the population that are part of the National Health Insurance Scheme. Tomorrow we will go to listen in hope to Prof Grange as she outlines her plans for reform. We hope that that in a few years time we would no longer be speaking about the times of Prof Ransome Kuti but the times of Prof Adenike Grange. Nigerians are hopeful…

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (www.epiafric.com), which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.